Business Cases

1. Business Cases

2. What is a Business Case? “A compilation of information to enable a decision to be reached in terms of making a change that affects the organisation. All key data is brought together and laid out so as to enable a methodical and objective review of the key determinants as required, in order to reach an informed decision.” NHS Library and Knowledge Services

3. What is a Business Case? • A written report or presentation • Focused on a business problem and solution options, or exploiting an opportunity • Justifies a business initiative or project

4. Why do we need Business Cases? • To ensure all developments are in line with Trust strategy and objectives • To ensure services are well planned • To ensure financial viability – best value • To ensure consequences have been assessed such as staffing, maintenance, etc. • To ensure risks have been assessed • To provide opportunity for wider stakeholders to input into the case. • To show that we have explored and evaluated the alternatives

5. Organisation requirements Before you start writing, remember to find out what your local policy is in terms of: • When a business case is needed • Governance requirements; • Processes to follow; • People to consult; • Authorisations to be gained.

6. Examples of Business Case Drivers Everything needs to be Clinically/Service Driven! J and P Associates

7. What do you think should be in a business case?

8. Evolution of a Business Case

9. Collaborative Working Clinicians need to be involved because: • Working in the front line • Know what needs to change • Have the knowledge of service developments and practice elsewhere • Close to recent academic and evidence based studies • Arguably, the only people who can deliver the solutions in full Finance team need to be involved to: • Ensure all costs are considered • Complete a comprehensive costing • Advise on assumptions • Steward you through the process

10. Engage your stakeholders • Know your audience • Present your ideas before you submit the business case • Ask for their feedback – make them a part of the solution • Address their concerns • Incorporate their suggestions • Ask for their support • Remember that any change to the status quo may be driven or blocked by your potential partners. Make them part of the process.

11. Why do Business Cases fail? • Not traceable to strategic goals • Alternative solutions appears to be a better fit • Affordability doesn’t outweigh risk • Unclear how benefits will be measured • Lack of confidence in your presentation • Senior stakeholders are not invested • Failure to determine workforce implications • Haven’t considered the impact on quality • Doesn’t clearly explain benefits to patients, staff or organisation • Poorly written • Too wordy, too much data, not the right level of info for the audience • Misspellings or misuse of grammar and punctuation.. • Not formatted properly or not in the preferred template • Incomplete • Missing information • No supporting data • Gaps in research

12. Top tips • Always provide the panel with a view on the options you have considered (as well as indicating your preferred option). One option should be to highlight the ramifications if we ‘Do Nothing’ • Engage Stakeholders • Involve finance team from the beginning • Make the links explicit as to how your Business Case initiative helps support your organisation in achieving its wider goals and mission

13. Is the need clearly stated? • Does the proposal contribute to the achievement of NHS policy and priorities, and the trust’s objectives and plans? • Are the benefits clearly stated? • Is it clear how the benefits will be realised? • Are the demand, capacity and income forecasts robust? • Are the capital and revenue costs robust? • Is it clear why the preferred option has been selected? • Is the project affordable? • Are the risks and plans to mitigate them explicitly stated? • Do the main stakeholders support the project? • Does the team have the capacity and capability to deliver it? • The British Association of Dermatologists Business Case Checklist

14. Emerging questions • How does the Business Case fit with the NHS LTP • How does the Business Case “fit” with the plans of the STP/HCP? • Are there opportunities to access transformational funding (CSF, PSF, ETTF)? • What impact will it have on the local health and social care economy “control total”? • How can we develop “win-win” projects which benefit both commissioners and providers? J and P Associates